GPs having to source own PPE ‘major planning failure’, finds Covid inquiry
A ‘major failure in planning’ by the Government meant GP practices had to source their own PPE during the early height of the Covid-19 pandemic, an inquiry has found.
The latest module of the Covid-19 Inquiry, which examined procurement and distribution of equipment, has condemned the fact the Government’s main procurement body did not supply PPE to GP practices, community health settings, pharmacies or dentists.
The report said: ‘The spread of Covid-19 had a devastating impact beyond hospitals. PPE was needed in a wide range of settings, especially in the social care sector, but the stockpile was not established for this purpose.
‘During a pandemic, the social care sector and community healthcare providers, such as GPs and pharmacists, were expected by the Department of Health and Social Care to procure their own PPE. Given the size of the social care sector and the vulnerability of those in care requiring protection from the spread of disease, this was a major failure in planning.’
The report explained that prior to the pandemic, the procurement body Supply Chain Coordination Ltd (owned at the time by DHSC) supplied about half of the PPE used by NHS trusts in England but did not supply anything to social care or primary care.
‘[The company] had not been instructed by the Department of Health and Social Care or Public Health England to create an emergency PPE distribution plan for a pandemic for the health and social care sectors in their entirety’, the report said.
To compound the issue, the report said when the ‘inadequate’ stockpile of PPE and other healthcare equipment ran dangerously low early in the pandemic amid huge demand from hospitals, Government contracts for replenishing the stock ‘failed’.
In the event of a pandemic, Public Health England (through Supply Chain Coordination Ltd) had ‘just-in-time’ contracts ready with PPE suppliers to replenish the pandemic stockpile for all four UK nations if needed.
However, the collapse of global supply chains caused by international demand for supplies meant ‘the contractors were unable to deliver the promised supplies’, leaving all care sectors ‘vulnerable to shortages’, the report concluded.
Report author Baroness Hallett also condemned the fact almost two thirds of Government spending on PPE during the pandemic – almost £10bn out of approximately £14.9bn – was ‘wasted’.
The report published the account of Dr David Bailey, a GP partner in Wales, who told the inquiry his GP practice received more help on PPE from local residents than from the health board.
Dr Bailey said: ‘Early on, scrubs were not provided by the local health board, and ours were made by patients. We are a community practice covering approximately 14,000 residents across three villages, and the community came together making scrubs for us and homemade visors for eye protection.’
Daniel Mortimer, deputy chief executive of the NHS Confederation and chief executive of NHS Employers between 2014 and 2026, told the inquiry that ‘NHS staff, including GPs’ found regulatory rules difficult to navigate as they tried to source PPE.
He advocated ‘simplifying’ these regulations and this was adopted by the report which recommended that the Government should ‘publish simplified regulations for emergency healthcare equipment’.
The inquiry’s future recommendations on PPE
The UK government and devolved administrations should publish simplified regulations for emergency healthcare equipment that are aligned with and cover the range and severity of pandemic risks identified in the National Security Risk Assessment.
The simplified regulations should:
- establish the minimum technical specifications of healthcare equipment specifically for use in a pandemic, including international standards that are recognised in the UK;
- clearly identify the regulator responsible for coordinating regulation, inspection and enforcement for each type of equipment; and
- be accompanied by a buyer’s guide that is easily understood by procurement officials, suppliers and end-users in the health and social care sectors.
The emergency healthcare equipment regulations and the buyer’s guide should be kept under review and updated in line with relevant changes to the National Security Risk Assessment.
Source: Covid-19 Inquiry
The BMA said the report revealed an ‘omnishambles’ in equipment procurement policy which led to GPs being ‘left with no protection as often asymptomatic patients sought help in their surgeries’.
BMA council deputy chair Dr Emma Runswick said today’s report charted the ‘multiple failures and missed opportunities that left doctors unprotected and patients exposed during the pandemic’.
‘Pandemic preparedness exercises were ignored, and assumptions about the type of disease we could face and how we might need to protect people against it were restrictive,’ she said.
‘It was assumed that PPE would only be needed in hospitals, and with symptomatic patients, explaining why our GP colleagues were left with no protection as often asymptomatic patients sought help in their surgeries.’
She added: ‘What we saw unfold was an omnishambles; a scramble in procurement, supply and distribution, resulting in chaotic and slapdash approaches to try to get PPE to those who needed it.’
Dr Runswick further said that despite the ‘very real’ threat of a new pandemic, health services ‘remain unprepared’.
‘Both in terms of supplies like PPE, but also in the state of the very buildings we work in, the facilities to provide critical care, and the staffing capacity we have to treat people.’
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